| Doctor Name: | DR. LUIS HERNAN RIVERA |
| NPI Number: | 1407989031 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 12394 |
| Business Practice Address: | Urb. Rio Canas Calle Amazonas #2936 Ponce, PR - 00728 |
| Business Phone Number: | 7875683966 |
| Business Fax Number: | |
| Mailing Address: | Urb. Rio Canas Calle Amazonas, #2936 PONCE |
| State: | PR |
| Postal Code: | 00728 |
| Phone Number: | 7875683966 |
| Fax Number: | |
| NPI Enumeration Date: | 03/13/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 12394 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |